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Illness perceptions and behavioural responses as mechanisms of change in problem‐solving treatment for Veterans with Gulf War Illness.

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Title: Illness perceptions and behavioural responses as mechanisms of change in problem‐solving treatment for Veterans with Gulf War Illness.
Authors: Lesnewich, Laura M. (AUTHOR), Winograd, Darren M. (AUTHOR), Lu, Shou‐En (AUTHOR), Quigley, Karen S. (AUTHOR), Pigeon, Wilfred R. (AUTHOR), Litke, David R. (AUTHOR), Helmer, Drew A. (AUTHOR), McAndrew, Lisa M. (AUTHOR)
Source: British Journal of Health Psychology. May2026, Vol. 31 Issue 2, p1-16. 16p.
Subjects: Problem-solving therapy, Medically unexplained symptoms, Cognitive structures, Behavior modification, Attitudes toward illness, Veterans' health, Self regulation, Persian Gulf syndrome
Abstract: Objective: Persistent 'medically unexplained' physical symptoms and syndromes (PPS), an umbrella term for symptom‐based conditions with poorly understood pathophysiology and aetiology, disproportionately impact Gulf War Veterans. Behavioural interventions are efficacious and recommended as first‐line treatments for PPS, but the mechanisms by which these interventions work remain unknown. This study sought to identify mechanisms of change that make problem‐solving treatment (PST) efficacious for Veterans living with Gulf War Illness (GWI), a common form of PPS among Veterans who served in Operations Desert Shield/Storm. Methods: Veterans with GWI were randomized to receive either PST or an active control intervention. Analyses focused on the 135 Veterans who were randomized to the PST condition. Outcomes of interest included disability, depressive symptoms, and physical symptoms. Threatening and protective illness perceptions as well as maladaptive and adaptive behavioural responses to illness were analysed as mechanisms of change (i.e., mediators) of these outcomes over time in single‐arm mediation models. Results: All three outcomes were mediated by reduced threatening illness perceptions (p‐values.032–.047) and reduced maladaptive behavioural responses (all‐or‐nothing and limiting responses; p‐values.004–.007). Changes in protective illness perceptions and adaptive behavioural responses to illness were not significant mediators of PST outcomes. Conclusions: Consistent with the cognitive behavioural model of PPS and the Common‐Sense Model of Self‐Regulation, changes in negative illness perceptions and behavioural responses may act as mechanisms of change in PST for GWI. [ABSTRACT FROM AUTHOR]
Copyright of British Journal of Health Psychology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Label: Title
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  Data: Illness perceptions and behavioural responses as mechanisms of change in problem‐solving treatment for Veterans with Gulf War Illness.
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  Data: <searchLink fieldCode="AR" term="%22Lesnewich%2C+Laura+M%2E%22">Lesnewich, Laura M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Winograd%2C+Darren+M%2E%22">Winograd, Darren M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lu%2C+Shou‐En%22">Lu, Shou‐En</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Quigley%2C+Karen+S%2E%22">Quigley, Karen S.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pigeon%2C+Wilfred+R%2E%22">Pigeon, Wilfred R.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Litke%2C+David+R%2E%22">Litke, David R.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Helmer%2C+Drew+A%2E%22">Helmer, Drew A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22McAndrew%2C+Lisa+M%2E%22">McAndrew, Lisa M.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22British+Journal+of+Health+Psychology%22">British Journal of Health Psychology</searchLink>. May2026, Vol. 31 Issue 2, p1-16. 16p.
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  Data: <searchLink fieldCode="DE" term="%22Problem-solving+therapy%22">Problem-solving therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Medically+unexplained+symptoms%22">Medically unexplained symptoms</searchLink><br /><searchLink fieldCode="DE" term="%22Cognitive+structures%22">Cognitive structures</searchLink><br /><searchLink fieldCode="DE" term="%22Behavior+modification%22">Behavior modification</searchLink><br /><searchLink fieldCode="DE" term="%22Attitudes+toward+illness%22">Attitudes toward illness</searchLink><br /><searchLink fieldCode="DE" term="%22Veterans'+health%22">Veterans' health</searchLink><br /><searchLink fieldCode="DE" term="%22Self+regulation%22">Self regulation</searchLink><br /><searchLink fieldCode="DE" term="%22Persian+Gulf+syndrome%22">Persian Gulf syndrome</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: Persistent 'medically unexplained' physical symptoms and syndromes (PPS), an umbrella term for symptom‐based conditions with poorly understood pathophysiology and aetiology, disproportionately impact Gulf War Veterans. Behavioural interventions are efficacious and recommended as first‐line treatments for PPS, but the mechanisms by which these interventions work remain unknown. This study sought to identify mechanisms of change that make problem‐solving treatment (PST) efficacious for Veterans living with Gulf War Illness (GWI), a common form of PPS among Veterans who served in Operations Desert Shield/Storm. Methods: Veterans with GWI were randomized to receive either PST or an active control intervention. Analyses focused on the 135 Veterans who were randomized to the PST condition. Outcomes of interest included disability, depressive symptoms, and physical symptoms. Threatening and protective illness perceptions as well as maladaptive and adaptive behavioural responses to illness were analysed as mechanisms of change (i.e., mediators) of these outcomes over time in single‐arm mediation models. Results: All three outcomes were mediated by reduced threatening illness perceptions (p‐values.032–.047) and reduced maladaptive behavioural responses (all‐or‐nothing and limiting responses; p‐values.004–.007). Changes in protective illness perceptions and adaptive behavioural responses to illness were not significant mediators of PST outcomes. Conclusions: Consistent with the cognitive behavioural model of PPS and the Common‐Sense Model of Self‐Regulation, changes in negative illness perceptions and behavioural responses may act as mechanisms of change in PST for GWI. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of British Journal of Health Psychology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=194051797
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        Value: 10.1111/bjhp.70062
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        Text: English
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        PageCount: 16
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        Type: general
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      – SubjectFull: Cognitive structures
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      – SubjectFull: Behavior modification
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      – SubjectFull: Attitudes toward illness
        Type: general
      – SubjectFull: Veterans' health
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      – SubjectFull: Self regulation
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      – SubjectFull: Persian Gulf syndrome
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              Text: May2026
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              Y: 2026
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